How cancer is treated

Cancer is treated in several different ways. Each type of cancer may be treated differently, depending on which treatments researchers have found to be most effective at killing a particular type of cancer cell. In some cases, several types of cancer treatments are given. The main types of cancer treatment are chemotherapy, radiation therapy, and surgery and stem-cell transplantation.

Chemotherapy is medicine that circulates throughout the body and stops cells from growing or causes cell death. Each type of chemotherapy stops cell growth or kills cells in a different way. When chemotherapy destroys cancer cells, healthy cells may also be damaged. Chemotherapy can be given by mouth, or into a vein, muscle, or spinal fluid.

You will receive written information about the different kinds of chemotherapy medicine that your child will receive. Common side effects of most chemotherapy medicines include nausea, vomiting, low blood counts, mouth sores, and hair loss. Some side effects happen right away while some occur months to years later. The type and severity of long-term side effects depends on the type of chemotherapy that is given. For example, some chemotherapy medicines can cause learning problems, while others can cause problems with fertility.

Radiation uses high-energy X-rays to kill or hurt rapidly growing cells, including cancer cells. Radiation can also damage healthy cells. Unlike chemotherapy, radiation does not cause cell damage throughout the body. Radiation only damages cells in the area of the body where the radiation is given.

If your child needs to receive radiation, the radiation field (area) will be measured precisely and marked on your child's body. This process is called simulation.

You can clean your child's skin with mild soap and water. Do not wash off the markings until after the radiation treatments are finished. You should not use any deodorant, creams, or talcum powder on your child's skin while your child is receiving radiation, unless ordered by the doctor or nurse in the radiation department. Radiation makes the skin very sensitive.

Side effects of radiation depend on the dose received and the area of the body that is treated. Mouth sores are a common side effect of radiation to the head or neck. If the hip bones are radiated, blood counts may become low. Sometimes side effects of radiation are not seen for months or years. For example, radiation to the head and spine can lead to decreased growth, hormone production problems and/or learning disabilities. Radiation to the pelvis can cause problems with fertility.

Different types of surgery are used to treat cancer. Taking out the tumor may be the only treatment needed, although usually chemotherapy or radiation is also used to kill any remaining cancer cells. Most surgeries take place in the operating room under general anesthesia.

Primary surgery removes all or most of the tumor at the time of diagnosis. Sometimes, due to size or the area of the body, the tumor cannot be safely removed right away. In this case, chemotherapy or radiation may be given before surgery to help shrink the tumor and make it easier to remove.

Second-look surgery is performed after treatment with chemotherapy, radiation or primary surgery. Surgeons are able to see how well the treatments have worked at killing the cancer cells, and may be able to remove any remaining tumor.

Supportive care surgery is done to help your child cope with cancer treatments. For example, your child may need surgery to have a central venous line (catheter) placed in a vein in the chest. This line will allow treatments to be given and blood samples taken without your child being “stuck” with a needle each time. If your child is not able to take food by mouth, a gastrostomy tube (G-tube) may be surgically placed into your child's stomach. The G-tube can be used to feed your child until your child can eat by mouth.

Bone marrow is the factory where blood cells are made. Bone marrow is found in the spongy part of bones, especially in the hips, ribs, breastbone and legs. The youngest type of blood cell is called a stem or progenitor cell. As a stem cell gets older, it becomes a white blood cell, red blood cell or platelet.

For some cancers, very high doses of chemotherapy and radiation are needed to get rid of all the cancer cells. These high doses of treatment may permanently destroy the normal stem cells in the bone marrow. The stem cells can be replaced with cells from the patient or a donor. This is called a stem-cell transplant.

The stem-cell donor may be the child with cancer, a relative, or someone not related to the child. If the child does not have cancer cells in his or her marrow, the child may be able to donate his or her own cells for a transplant. This type of transplant is called an autologous stem cell transplant. If the child's bone marrow has cancer cells, healthy stem cells are usually donated by a relative or someone not related to the child. This type of treatment is called an allogeneic transplant.

If your child needs a stem cell transplant, a member of our stem-cell transplant team will talk with you about the type of transplant that is best for your child.